The investigators are doing this research for two reasons. The first is to see how the
retina (back of your eye) changes when your blood sugar is treated with medication for the
first time. This will help us better understand the progression of a condition known as
Diabetic Retinopathy. The second reason is to provide diabetic blood samples, which will
possibly help identify biomarkers for diabetic retinopathy. Biomarkers are things that
indicate the presence of a specific condition, and indicate a higher likelihood of
developing that condition.
The goal of this research is to conduct a study that investigates (1) how diabetic
retinopathy progresses when poorly controlled Type 2 diabetic patients initiate intensive
blood sugar control and (2) to determine if there are biomarkers that predict progression of
diabetic retinopathy. Typically, the retina is thought to undergo rapid progression of
diabetic retinopathy, although this has been poorly characterized in a formal study.
The first goal will be quantified by taking initial photos of the retina with the Pictor
Plus hand-held fundus camera, as well as monthly photos (when the patient is scheduled for
their endocrinology appointments, throughout a 90 day period). The second goal will be
accomplished by testing the patient's blood. There will be an initial blood withdraw, as
well as blood withdraws at monthly intervals throughout the same 90 day period as the fundus
This study will help us to understand the pathogenesis of diabetic retinopathy, as well as
potentially lead to an improved understanding of progression of diabetic retinopathy.
- Presenting to the endocrinology clinic with a hemoglobin A1c of greater than 12.
- Patients with other ocular or systemic conditions, including macular degeneration,
uveitis, glaucoma, and autoimmune conditions (Rheumatoid Arthritis, Lupus, and other